This invention relates generally to medical products for use during surgical procedures. More particularly, this invention relates to an improved so-called visceral retractor for protecting internal patient organs during closure of a surgical incision or the like.
In many types of surgical procedures, such as abdominal surgery, an incision is made through several outer tissue layers to gain access to internal patient organs, such as the intestines or the like. At the conclusion of the surgery, the tissue layers are sutured to close the incision. However, particularly with abdominal surgery, incision suturing can be a difficult and tedious procedure, since the underlying internal organs may bulge upwardly into the incision. This undesirably exposes the organs to possible damage from puncture during the suturing process and further subjects partially sutured tissue layers to stress which can cause tearing.
There exists, therefore, a need for a surgical device or appliance which can be used to separate internal patient organs from overlying tissue layers during incision closure at the conclusion of a surgical procedure. Such a device, referred to as a visceral retractor, must be adapted for relatively easy insertion through the incision to a position immediately underlying the tissue layers. In this position, the retractor must be capable of being held easily by the surgeon to retract patient organs from the incision without interferring with the suturing process and further must be adapted for removal from the patient after the incision is substantially closed. Moreover, the visceral retractor is desirably provided in a form which is inexpensive to manufacture, easy to sterilize, capable of use with incisions of different sizes, and preferably disposable after use.
One visceral retractor presently on the market is provided in the form of a generally oval flexible plastic or rubber-based sheet for insertion through the incision between overlying tissue layers and underlying patient organs. The oval sheet is structurally reinforced by a central metal bar and by thickened ribs radiating therefrom for retracting patient organs from the incision, and a string or the like is attached to one end of the retractor to support a plastic safety ring outside the incision to prevent the retractor from being left inadvertently within the patient. While visceral retractors of this type perform satisfactorily during initial closure of a relatively large incision, they must be removed from the patient relatively early in the suturing procedure to avoid being trapped within the patient, thereby leaving a substantial portion of the suturing process to be performed without the assistance of a visceral retractor or requiring the use of a separate device such as a hand-held metal bar, to separate the overlying tissue layers from the underlying organs, for the final four-to-five inches of suturing. Moreover, it has been found that the string and safety ring tend to shift about and interfere with the suturing process.
The present invention overcomes the problems and disadvantages of the art by providing an improved visceral rectractor which is specifically shaped for use throughout a suturing process until the incision is substantially closed. The invention is thereby also usable with large and small incisions to eliminate any requirement to provide several retractors of different sizes.